MRS. SUSAN KATHLEEN FAIREY (NPI# 1215135876) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215135876 |
| Entity Type | Individual |
| Full Name | MRS. SUSAN KATHLEEN FAIREY |
| Credential | MFT |
| Practice Address |
4990 Speak Lane San Jose CA 95118 |
| Practice Telephone | 4082667826 |
| Practice Fax Number | 4082679649 |
| Mailing Telephone | 4082667826 |
| Mailing Fax Number | 4082679649 |
| Enumeration Date | 2007-07-05 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106H00000X | Marriage & Family Therapist | LMFT7641 | CA | Behavioral Health & Social Service Providers |
| Street Address |
4990 SPEAK LANE |
| City | SAN JOSE |
| State | CA |
| Zip Code | 95118 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326249954 | Marcia May Kaufmann | Social Worker | 4990 Speak Lane, Suite 100, San Jose, CA 95118 | 2007-05-30 |
| 1659578854 | Janet Jensen Roberts | Marriage & Family Therapist | 4990 Speak Lane, Ste 100, San Jose, CA 95118 | 2007-06-29 |
| 1235335951 | Diane Carole Petroni | Psychologist | 4990 Speak Lane, Suite 100, San Jose, CA 95118-2776 | 2007-06-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235620907 | Misty Henne-bhullar Dmd Inc. | Dentist | 4984 Cherry Ave, San Jose, CA 95118 | 2018-05-29 |
| 1770013096 | Eunju Bang | Acupuncturist | 3315 Almaden Expy Ste 27, San Jose, CA 95118 | 2017-06-19 |
| 1306299391 | Satellite Healthcare Inc | Clinic/Center | 1450 Kooser Road, San Jose, CA 95118 | 2016-07-14 |
| 1881060739 | Brittany Star Curry | Physical Therapist | 3150 Almaden Expy Ste 120, San Jose, CA 95118 | 2015-08-14 |
| 1154690188 | Carrie Herbst | Marriage & Family Therapist | 1390 Dentwood Dr, San Jose, CA 95118 | 2011-12-20 |
| 1104096825 | Cheryl Ann Engelstad | Marriage & Family Therapist | 1455 E Foxworthy Ave, Pmb 159, San Jose, CA 95118 | 2008-03-10 |
| 1427251271 | Eric John Bohl | Marriage & Family Therapist | 4990 Speak Ln., Suite 100, San Jose, CA 95118 | 2007-06-08 |
| 1386796498 | Rena Jean Zahorsky | Marriage & Family Therapist | 4990 Speak Lane Suite 100, San Jose, CA 95118 | 2007-01-17 |
| 1992885883 | Minoo Mehdikhan | Psychologist | 1131 Luchessi Dr Suite 2, San Jose, CA 95118 | 2006-10-16 |
| 1164518759 | Nadia Ajluni | Chiropractor | 4986 Cherry Ave., San Jose, CA 95118 | 2006-10-04 |
| Find all providers in zip 95118 | ||||
| Taxonomy Code | 106H00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Marriage & Family Therapist |
| A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598372377 | Ratzburg Family Counseling Corporation | Marriage & Family Therapist | 465 Chinook Ln, San Jose, CA 95123-3311 | 2020-09-25 |
| 1285245431 | Carmen J. Frank | Marriage & Family Therapist | 913 Willow St., Suite 103, San Jose, CA 95125 | 2020-08-12 |
| 1083230981 | Joanna Leigh Carson-young | Marriage & Family Therapist | 1769 Park Ave Ste 220, San Jose, CA 95126-2025 | 2020-06-17 |
| 1144857467 | Glenn M Tanimura | Marriage & Family Therapist | 1079 Noble Ln, San Jose, CA 95132-3128 | 2020-03-25 |
| 1265067185 | Of Two Minds Psychotherapy | Marriage & Family Therapist | 190 S. Bascom Ave, Ste 130, San Jose, CA 95128 | 2020-03-11 |
| 1992339196 | Brenda Ann Farrell | Marriage & Family Therapist | 1625 The Alameda Ste 711, San Jose, CA 95126-2225 | 2020-02-26 |
| 1619507472 | Michelle Marie Wambach | Marriage & Family Therapist | 4020 Moorpark Ave Ste 206, San Jose, CA 95117-1846 | 2020-01-21 |
| 1699313080 | Juan Carlos Mercado | Marriage & Family Therapist | 290 North 2nd St, San Jose, CA 95112 | 2019-12-16 |
| 1497398002 | Veronica Marie Ayala | Marriage & Family Therapist | 840 Guadalupe Pkwy Fl 2, San Jose, CA 95110-1714 | 2019-10-26 |
| 1700428224 | Lynn Huggins | Marriage & Family Therapist | 1625 The Alameda Ste 304, San Jose, CA 95126-2223 | 2019-10-16 |
| Find all providers in SAN JOSE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.